Coastal Health Primary Care Llc - Medicare Primary Care in Orange Park, FL

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Coastal Health Primary Care Llc is a medicare enrolled primary clinic (Family Medicine) in Orange Park, Florida. The current practice location for Coastal Health Primary Care Llc is 705 Wells Rd Ste 300, Orange Park, Florida. For appointments, you can reach them via phone at (904) 282-6331. The mailing address for Coastal Health Primary Care Llc is 705 Wells Rd Ste 300, Orange Park, Florida and phone number is (904) 282-6331.

Coastal Health Primary Care Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1023734340. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (904) 282-6331.

Contact Information

Coastal Health Primary Care Llc
705 Wells Rd Ste 300
Orange Park
FL 32073-2982
(904) 282-6331
(904) 619-1080

Map and Direction


Primary Care Clinic Profile

Full NameCoastal Health Primary Care Llc
SpecialityFamily Medicine
Location705 Wells Rd Ste 300, Orange Park, Florida
Authorized Official Name and PositionAndrew T Christman (CEO)
Authorized Official Contact9416857688
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Coastal Health Primary Care Llc
705 Wells Rd Ste 300
Orange Park
FL 32073-2982

Ph: (904) 282-6331		Coastal Health Primary Care Llc
705 Wells Rd Ste 300
Orange Park
FL 32073-2982

Ph: (904) 282-6331

NPI Details:

NPI Number1023734340
Provider Enumeration Date10/18/2022
Last Update Date04/26/2024

Medicare PECOS Information:

Medicare PECOS PAC ID8628447380
Medicare Enrollment IDO20221220001103

Medical Identifiers

Medical identifiers for Coastal Health Primary Care Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023734340NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Coastal Health Primary Care Llc acts as a billing entity for following providers:
Provider NameHeather M Wade
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033136072
PECOS PAC ID: 8820990070
Enrollment ID: I20040127000302
Provider NameBarbara A Trunzo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336146356
PECOS PAC ID: 2567365315
Enrollment ID: I20040129000250
Provider NameJohn A Muenz
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1811030430
PECOS PAC ID: 7517926991
Enrollment ID: I20041011000294
Provider NameRebecca A Didi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306862958
PECOS PAC ID: 5193789501
Enrollment ID: I20041116000481
Provider NameJorge B Caballero
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356383384
PECOS PAC ID: 8729083860
Enrollment ID: I20060925000446
Provider NameMichael A Edwards
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437355302
PECOS PAC ID: 6406911486
Enrollment ID: I20090209000423
Provider NameTina M Voisin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437483278
PECOS PAC ID: 4587703798
Enrollment ID: I20091201000568
Provider NameJames W Fetchero
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750301586
PECOS PAC ID: 4981501228
Enrollment ID: I20100203000567
Provider NameDouglas Pennington
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1891714580
PECOS PAC ID: 7911804257
Enrollment ID: I20100203000720
Provider NameGene Harris
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912926700
PECOS PAC ID: 5092612333
Enrollment ID: I20100205000533
Provider NameKent Braeutigam
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1063437861
PECOS PAC ID: 0345147690
Enrollment ID: I20100315000113
Provider NameMohammad H. Aboushaar
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1194740993
PECOS PAC ID: 3971400227
Enrollment ID: I20100324001138
Provider NameThomas M Hardin
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1174542955
PECOS PAC ID: 1456258797
Enrollment ID: I20100324001170
Provider NameLynn M Waters
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1487840633
PECOS PAC ID: 5395871958
Enrollment ID: I20100407000510
Provider NameBenjamin W Goh
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821013459
PECOS PAC ID: 1355248691
Enrollment ID: I20100416000293
Provider NameRobert Dajac
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104841915
PECOS PAC ID: 0345147682
Enrollment ID: I20100607000510
Provider NameRasheed A Awan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1326022948
PECOS PAC ID: 8527199082
Enrollment ID: I20100626000474
Provider NamePeter Masterson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679986129
PECOS PAC ID: 6608092416
Enrollment ID: I20140730001774
Provider NameSarah Graham
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891108767
PECOS PAC ID: 4183844988
Enrollment ID: I20140929002666
Provider NameSarah C Kern
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1649553439
PECOS PAC ID: 5890015051
Enrollment ID: I20150529000837
Provider NameScott T Marberry
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1972914174
PECOS PAC ID: 9436435245
Enrollment ID: I20170410002650
Provider NameAmanda G Adams
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841711165
PECOS PAC ID: 4688947997
Enrollment ID: I20170908001082
Provider NameHeather Pauline Bennett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1316432503
PECOS PAC ID: 2860741220
Enrollment ID: I20180817000500
Provider NameMelanie Abboud
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659994598
PECOS PAC ID: 5395167522
Enrollment ID: I20200617000802
Provider NameSarah J Gomez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003425604
PECOS PAC ID: 3678999299
Enrollment ID: I20200813001327
Provider NameKatherine Morgan Hamilton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275142853
PECOS PAC ID: 6204247398
Enrollment ID: I20201120001645
Provider NameJennifer Marie Sidey
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1518496975
PECOS PAC ID: 2365791787
Enrollment ID: I20210615000605
Provider NameDian Krystle Daher
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1417390709
PECOS PAC ID: 8022413301
Enrollment ID: I20210825000664
Provider NameShameka Danielle King
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093478331
PECOS PAC ID: 5799173795
Enrollment ID: I20211025001450
Provider NameCaleb Firmstone Dunlap
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104386473
PECOS PAC ID: 1759616410
Enrollment ID: I20220708002323
Provider NameKaitlyn Nicole Kaczka
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1134709884
PECOS PAC ID: 4587045224
Enrollment ID: I20220713000738
Provider NameAmy Christine Powell
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245950773
PECOS PAC ID: 9133595614
Enrollment ID: I20221025002042
Provider NameVictoria Ann Jacobs
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1417562877
PECOS PAC ID: 7416357413
Enrollment ID: I20221129001160

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.